Examplify Med-Surg

Free preview · Original latest version

Sample questions from Examplify Med-Surg

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.In the emergency department, a 17-year-old client reports sudden palpitations and lightheadedness. The monitor shows a regular narrow-complex tachycardia at 190 beats/min; blood pressure is 118/72 mm Hg, and the client is alert. Which action should the nurse anticipate first?

   • A.Prepare for synchronized cardioversion
   • B.Coach the client to perform a vagal maneuver
   • C.Begin chest compressions
   • D.Administer intravenous adenosine without attempting other measures

   Rationale: A stable client with a regular narrow-complex tachycardia should generally be treated first with a vagal maneuver. Synchronized cardioversion is used when the client is unstable or when appropriate less invasive treatment is ineffective. Adenosine may be prescribed if vagal maneuvers fail, while chest compressions are not indicated for an alert client with a pulse. The exam takeaway is to assess stability before selecting treatment for tachycardia.

2. 2.Refer to the client's chart. Which findings support worsening heart failure and require prompt follow-up? Select all that apply.

   • A.Urine output is 45 mL/hr
   • B.New crackles are heard at both lung bases
   • C.Weight increased by 1.8 kg in 24 hours
   • D.SpO2 decreased from 95% to 89% on room air
   • E.Heart rate decreased from 92 to 88 beats/min

   Rationale: The 1.8 kg weight gain in 24 hours, falling SpO2, and new bilateral crackles indicate fluid retention and worsening pulmonary congestion. A urine output of 45 mL/hr is not, by itself, evidence of oliguria in this adult, though the trend should still be monitored. A heart rate change from 92 to 88 beats/min is not a concerning deterioration on its own. In heart failure, rapid weight gain and respiratory changes warrant prompt assessment and escalation.

3. 3.A client states, "I take warfarin, and my stool has been black and sticky since yesterday." Which response by the nurse is the priority?

   • A.Ask the client to increase dietary vitamin K today
   • B.Reassure the client that dark stool is an expected effect of warfarin
   • C.Instruct the client to hold the next dose and contact the prescriber promptly
   • D.Advise the client to take the medication with food

   Rationale: Black, tarry stool can indicate gastrointestinal bleeding, a serious complication of warfarin therapy, and requires prompt evaluation. Increasing vitamin K without guidance is not an appropriate response to possible bleeding. Dark stool is not an expected benign effect of warfarin, and taking the medication with food does not address the potential hemorrhage. The exam takeaway is to recognize bleeding cues and escalate care rather than offering routine medication teaching.

4. 4.At a community clinic, a 42-year-old client with hypertension asks how to reduce sodium intake. Which meal choice best supports that goal?

   • A.Canned vegetable soup and a ham sandwich
   • B.Frozen pepperoni pizza and canned tomato juice
   • C.Instant noodles with packaged seasoning and a side of pickles
   • D.Baked chicken, brown rice, and fresh green beans

   Answer and rationale are in the full material.

5. 5.A client's potassium is 6.1 mEq/L, and the electrocardiogram shows peaked T waves. Which prescribed intervention should the nurse implement first?

   • A.Administer intravenous calcium gluconate
   • B.Give oral potassium chloride with food
   • C.Administer a potassium-sparing diuretic
   • D.Encourage foods rich in potassium

   Answer and rationale are in the full material.